Neuroimaging technique identifies concussion-related brain disease in living brain

PUBLIC RELEASE DATE:

16-Sep-2014

Contact: Elizabeth Dowling newsmedia@mssm.edu 212-241-9200 The Mount Sinai Hospital / Mount Sinai School of Medicine @mountsinainyc

An experimental positron emission tomography (PET) tracer is effective in diagnosing concussion-related brain disease while a person is still alive, according to a case study conducted at the Icahn School of Medicine at Mount Sinai, and at Molecular Neuroimaging (MNI) LLC in New Haven, and published September 16 in the journal Translational Psychiatry.

Specifically, the study results suggest that an experimental radiolabeled compound called [18 F]-T807, which is designed to latch onto a protein called tau that accumulates in the brain with repetitive blows to the head, can be registered on a PET scanner to effectively diagnose chronic traumatic encephalopathy (CTE). The study results also argue the process can differentiate it from other forms of dementia while the sufferer is still alive. Until now, CTE diagnosis has only been possible by evaluating post-mortem brain tissue.

"Our data suggest that PET imaging using the [18F]-T807 tau tracer is an effective method of diagnosing or ruling out chronic traumatic encephalopathy in a living brain," says Samuel Gandy, MD, Director of the Center for Cognitive Health and NFL Neurological Care at the Icahn School of Medicine at Mount Sinai. "Estimates of the prevalence of CTE have varied wildly, with the most recent figure coming from the National Football League who predicts that one in three NFL players will suffer significant brain damage. We can now begin to test this while the players are still alive. Moreover, we are now equipped to tell prospective athletes of all ages some real data on the risks that accompany sports involving repeated traumatic brain injuries."

Signs of CTE were originally spotted in boxers and retired National Football League (NFL) players. Before their deaths, many of these athletes struggled with symptoms like memory loss, depression, and violent outbursts, and in some cases they became suicidal. The NFL is currently helping to launch large-scale studies of the condition. More recently, the brains of ice hockey players and battlefield veterans exposed to repeated bomb blasts have revealed evidence of CTE.

In recent years, scientists have developed radiotracers like [18F]-T807 that attach to protein aggregates and emit high-energy particles called positrons that are registered on a PET scanner. The [18F]-T807 tau tracer selectively binds only to tangles of tau in the brain and not to amyloid proteins associated with Alzheimer's disease, making it superior to other proposed tau tracers to date in terms of CTE detection, according to the study authors.

The Mount Sinai case study included the evaluations of two living patients, a retired NFL football player with a history of multiple concussions and a patient with a single, severe traumatic brain injury (TBI). Both patients presented with cognitive decline and suspected AD. Both were evaluated by a combination of molecular imaging techniques to pinpoint specific brain disease and damage

Brain injury, whether as a result of repeated head trauma or a single, traumatic brain event, may jumpstart a process whereby tau protein, which functions in a healthy brain to help stabilize a nerve cell's protein skeleton, breaks off the skeleton and begins to build up inside nerve cells. The theory is that tangles of tau protein accumulate and cause nerve cell damage in the CTE brain.

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Neuroimaging technique identifies concussion-related brain disease in living brain